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Contract 54220-FP1A1
City Secretary 54220-FPlA1 Contract No. FORT WORTH, Date Received 03/22/2022 AMENDED NOTICE OF PROJECT COMPLETION (Developer Projects) On October 7, 2021, a Notice of Project Completion was executed by the City for the Project named below and filed with the City Secretary as City Secretary Contract Number 54220- FP1. This Amended Notice of Project Completion is being executed and filed with the City Secretary to document a more detailed description of the City Participation in the project, to reflect an additional change order that was executed to correct the City Participation in the contract, and to correct errors in the original Notice of Project Completion. The Transportation and Public Works Department upon the recommendation of the Project Manager has accepted the following project as complete: Project Name: Northside III Offsite Water Improvements City Project No.: 102240 Improvement Type(s): Water 0 Sewer ❑ Developer Cost City Cost Total Original Contract Price: $6,293,711.86 $2,486,288.14 $8,780,000.00 Amount of Approved Change Order(s): $445,614.50 -$326,880.65 $118,733.85 Revised Contract Amount: $6,739,326.36 $2,159,407.79 $8,898,733.85 Total Cost of Work Complete: $6,739,326.36 $2,159,407.79 $8,898,733.85 City Portion Total Cost Work Completed: $2,159,407.79 Less Previous Payments: $1,590,108.86 Final Payment Due: $ 569,298.63 Mar 14,2022 Contractor- Tyler McKee Date Executive Vice President Title McKee Utility Contractors, Inc Company Name /fnprhgl c�?aliLg� c26tg!'�W W OFFICIAL RECORD Hershel Stanley Sutterfield(Mai15,202204:04C T) Mar 15,2022 CITY SECRETARY Project Inspector- Hershel Sutterfield Date FT. WORTH, TX Page 1 of 2 Loa sh Patel, P.E. Mar 17,2022 Yogesh Patel,P.E.(Mar 17,2022 10:14 CDT) Project Manager-Yogesh Patel Date We Scarlett Morales(Mar 17,202210:23 CDT) Mar 17,2022 CFA Manager- Janie S. Morales Date Aw XWhWW Mar 17 2022 Dana Bur�17,202fP:51 CDT) Asst. City Manager- Dana Burghdoff Date Notice of Project Completion Project Name: Northside III Offsite Water Improvements City Project No.: 102240 City's Attachments Final Pay Estimate ❑x Change Order(s): ❑x Yes ❑ N/A Pipe Report: ❑x Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 187 WD Days Charged: 218 Work Start Date: 8/24/2020 Work Complete Date: 8/20/2021 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Page 2 of 2 City Secretary Contract No, 54220 -FP1 FORTWORTH, Dale Received Oct 7,2021 NOTICE OF PROJECT COMPLETION (Developer Projects) The Transportation and Public Works Department upon the recommendation of the Project Manager has accepted the following project as complete: Project Name: Northside III Offsite Water Improvements City Project No.: 102240 Improvement Type(s): Water ❑x Sewer rXI Original Contract Price: $8,780,000.00 Amount of Approved Change Order(s): $118,733.85' Revised Contract Amount: Total Cost of Work Complete: $8,898,733.85 Oct 7,2021 Contractor Date Executive Vice President Title McKee Utility Contractors, Inc Company Name Hershel Stan ey Butterfield(Oct 7,202111:15 CDT) Oct 7,2021 Project Inspector Date ges atel,PE(Oct 7,202112:39 CDT) Oct 7,2021 Project Manager Date " Oct 7,2021 Evelyn Ro its(Oct 7,202112:40 CDT) CFA Manager Date ` alleg kqkW� Oct 7 2021 Dana Burghdoff(Occ7,2021 CDT) Asst. City Manager Date Page 1 of 2 Notice of Project Completion Project Name: Northside III Offsite Water Improvements City Project No.: 102240 City's Attachments Final Pay Estimate Change Order(s): © Yes ❑ N/A Pipe Report: ® Yes ❑ N/A Contractor's Attachments Affidavit of Bills Paid Consent of Surety Statement of Contract Time Contract Time: 187 WD Days Charged: 218 Work Start Date: 8/24/2020 Work Complete Date: 8/20/2021 Completed number of Soil Lab Test: 474 Completed number of Water Test: 56 Page 2 of 2 FORTWORTH CITY OF FORT WORTH FINAL PAYMENT REQUEST Contract Name NORTHSIDE III OFFISITE WATER IMPROVEMENTS Contract Limits TO SERVE TRADITION,CENTRAL PHASE Project Type WATER City Project Numbers 102240 DOE Number 2240 Estimate Number I Payment Number I For Period Ending 9/30/2021 WD City Secretary Contract Number Contract Time 18WD Contract Date Days Charged to Date 218 Project A4anager NA Contract is 100.00 Complete Corti-actor McKee Utility Inc. 2319 W Main Street Prauge, OK 74864 Inspectors MILLER,W / SUTTERFIELD f 'Thursday,October 7,2021 Page I of 7 City l'roject Numbers 102240 DOE Nilml)el' 2240 Contract Name NORTFISIDE Ill OFFISITE WATER IMPROVEMENTS Estimate Number I Contract Limits TO SERVE TRADITION,CENTRAL PHASE Payment Number 1 Project Type WATER For Period Ending 9/30/2021 Project Funding t1NTF I:WATER IMPROVEMENTS BASE BID Item Descriptiou of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanily Total --------------------------------------- I REMOVE SIDEWALK 510 SF $1.00 $510.00 510 $510.00 2 REMOVE FENCE(CO 4) 5290 LF $0.50 $2,645.00 5290 $2,645.00 3 SITE CLEARING 14.1 AC $10,000.00 S141,000.00 14.1 $141,000.00 4 SWPPP I LS $15,000.00 $15,000.00 1 $15,000.00 5 LARGE.STONE RIPRAP(CO 4) 240 SY $50.00 $12,000.00 240 $12,000.00 6 ASPHALT PVMT REPAIR BEYOND DEFINED 68 SY $1.00 $68.00 68 $68.00 WIDTI1 7 HYDRATED LIME 3.14 TN $1.00 $3.14 3.14 $3.14 8 10"LIME TREATMENT 264 SY $2.00 $528.00 264 $528.00 9 10"CONC PVMT 184 SY $100.00 $18,400.00 184 $18,400.00 10 1 V CONC PVMT 112 SY $100.00 $11,200.00 112 $11,200.00 I 1 O WIDE SIDEWALK 514 SF $5.00 $2,570.00 514 $2,570.00 12 BARBERD WIRE FENCE,METAL POSTS(CO 4) 5290 LF $2.50 $13,225.00 5290 $13,225.00 13 TOPSOIL 1874 CY $2.50 $4,685.00 1874 $4,685.00 i 14 BLOCK SOD PLACEMENT 11246 SY $5.00 $56,230.00 11246 $56,230.00 15 SEEDING 142386 SY $0.25 $35,596.50 142386 $35,596.50 16 POST CCTV INSPECTION 20572 LF $1.50 $30,858.00 20572 $30,858.00 17 TRENCH SAFETY 20572 LF $0.50 $10,286.00 20572 $10,286.00 18 UTILITY MARKERS 1 LS $2,500.00 $2,500.00 1 $2,500.00 19 12"PVC WATER PIPE 51 LF $50.00 $2,550.00 51 $2,550.00 20 CONNECTION TO EXISTING 16"WATER MAIN 2 EA $5,000.00 $10,000.00 2 $10,000.00 21 CONNECTION TO EXISTING 36"WATER MAIN 2 EA $40,000.00 $80,000.00 2 $80,000.00 22 CONNECTION TO EXISTING 4" 12"WATER 1 EA $1,500.00 $1,500.00 1 $I,500.00 MAIN 23 2"COMBINATION AIRE VALVE ASSEMBLY 2 EA $10,000.00 $20,000.00 2 $20,000.00 FOR WATER 24 12"GATE VALVE I EA $2,000.00 $2,000.00 1 $2,000.00 25 6"BLOW OFF VALVE 2 EA $25,000.00 $50,000.00 2 $50,000.00 26 8"BLOW OFF VALVE 7 EA $30,000.00 $210,000.00 7 $210,000.00 27 5'MANHOLE I EA $20,000.00 $20,000.00 1 $20,000.00 28 TRAFFIC CONTROL 4 MO $1,000.00 $4,000.00 4 $4,000.00 29 REMOVE&REPLACE EXISTING GRAVEL 5577 SY $10.25 $57,164.25 5577 $57,164.25 DRIVE Thursday,October 7,2021 Page 2 of 7 City Project Numbers 102240 DOE Number 2240 Contract Name NORTHSIDE III OFFISITE WATER IMPROVEMENTS Estimate Number I Conti-act Limits TO SERVE TRADITION,CENTRAL PHASE Payment Numbcr I I'roject'lrype WATER For Period Ending 9/30/2021 Project Funding 30 TEMPORARY 8'WIDE GRAVEL ROAD 3461 SY $6.00 $20,766.00 3461 $20,766.00 31 REMOVE&REPLACE IRON CAT'I'LEGUARD& 3 EA $1,600.00 $4,800.00 3 $4,800.00 GATE 32 PRESSURE:RELEASE VALVE I LS $30,000.00 $30,000.00 1 $30,000,00 33 PRESSURE RELEASE VALVE ELECTRICAL I LS $95,000.00 $95,000.00 1 $95,000.00 COMPONENTS 34 PRESSURE RELEASE VALVE VAULT I LS $55,000.00 $55,000.00 1 $55,000.00 35 REMOVE EX FLUSH VALVE ENCLOSURE& I LS $6,000.00 $6,000.00 1 $6,000.00 CONTROLS 36 INSTALLWIREGATE 1 EA $500.00 $500.00 1 $500.00 -------------------------------------- Sub-Total of Previous Unit $1,026,584.89 $1,026,584.89 UNIT 2:PRV ACCESS DRIVE INIPROVENIENTS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 39 O CHAIN LINK FENCE 164 LF $25.00 $4,100.00 164 $4,100.00 42 EXCAVATION 345 CY $10.00 $3,450.00 345 $3,450.00 43 4"ACP(CO 4) 256 SY $100.00 $25,600.00 256 $25,600.00 44 8"L T S AND SELECT MATERIAL 101 SY $7.00 $707.00 101 $707,01 45 CRUSHED GRAVEL(CO 4) 182 SY $7.00 $1,274.00 182 $1,274.00 -------------------------------------- Sub-Total of Previous Unit $35,131.00 $35,131.00 ALTERNATE IA BID Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- 1 36"DIP WATER 11623 LF 2 36"STEEL AWWA C200 WATER PIPE 11623 LF 3 36"CONCRETE AWWA C303 WATER PIPE 11623 LF $205.00 :,382,715.00 11623 2,382,715.00 4 36"DIP WATER,CSS BACKFILL 101 LF 5 36"STEEL AWWA C200 WATER PIPE CSS 101 LF BACKFILL 6 36"CONCRETE AWWA C303 WATER PIPE CSS 101 LF $235.00 $23,735.00 101 $23,735.00 BACKFILL 7 36"DIP WATER RESTRAINED JOINTS 8244 LF 8 36"STEEL AWWA C200 WATER PIPE 8244 LF RESTRAINED JOINTS Thursday,October 7,2021 Page 3 of 7 City Project Numbers 102240 DOE Number 2240 Contract Name NORTHSIDE III OFFISITE WATER IMPROVEMENTS Estimate Number I Contract Limits TO SERVE TRADITION,CENTRAL PHASE Payment Number I Project Type PAVING&ALT For Period Ending 9/30/2021 Project Funding 9 36"CONCRETE AWWA C303 WATER PIPE 8244 LF $235.00 ,937,340.00 8244 1,937,340.00 RESTRAINED JOINTS 10 DUCTILE IRON WATER FITTINGS 21.09 TN W/RESTRAINT 36"PIPE 11 36"STEEL PIPE FITTINGS I LS 12 36"CONCRETE PIPE FITTINGS I LS $87,255.11 $87,255.11 1 $87,255.1 1 13 6"COMBINATION AIR VALVE ASSEMBLY FOR 6 EA $20,000.00 $120,000.00 6 $120,000.00 WATER 14 36"AWWA BUTTERFLY VALVE W/VAULT 13 EA $85,000.00 ,105,000.00 13 1,105,000.00 15 36"WATER CARRIER PIPE 604 LF $110.00 $66,440.00 604 $66,440.00 16 54"CASING BY OTHER THAN OPEN CUT 604 LF $2,000.00 ,208,000.00 604 1,208,000.00 17 CATHODIC PROTECTION FOR 36"PIPE 1 LS $30,000.00 $30,000.00 1 $30,000.00 18 ADDITIONAL WATER LINE DEPTH(CO 1) 1 LS $87,481.49 $87,481.49 1 $87,481.49 -------------------------------------- Sub-Total of Previous Unit — $7,047,966.60 $7,047,966.60 i ALTERNATE 2A BID i Item Description of Items Estimated Unit Unit Cost Estimnted Completed Completed No. Quanity Total Quanity Total ---- ------------------- ——————————— ---- 1 16"WATER PIPE,CSS BACKFILL 20 LF $60.00 $1,200.00 20 $1,200.00 2 16"DIP WATER(RESTRAINED JOINTS) 16 LF $45.00 $720.00 16 $720.00 3 16"PVC C905 WATER PIPE 1704 LF $90.00 $153,360.00 1704 $153,360.00 4 16"PVC C905 WATER PIPE(RESTRAINED 330 LF $100.00 $33,000.00 330 $33,000.00 i JOINTS) 7 16"(DIP)WATER CARRIER PIPE 301 LF $100.00 $30,100.00 301 $30,100.00 8 DUCTILE IRON WATER FITTINGS 0.42 TN $3,500.00 $1,470.00 0.42 $1,470.00 W/RESTRAINT(16"PIPE) 9 16"GATE VALE W/VAULT(CO 2) 3 $10,000.00 $30,000.00 3 $30,000.00 10 ADDITIONAL PUC AND ACCESSORIES(CO 2) 1 LS $2,127.50 $2,127.50 1 $2,127.50 11 COATED 30'CASINB BY OPEN CUT(CO 3) 111 LF $315.86 $35,060.46 111 $35,060.46 12 COATED 30'CASING BY OTHER THAN OPEN 190 LF $2,115.86 $402,013.40 190 $402,013.40 CUT(CO 3) -------------------------------------- Sub-Total of Previous Unit $689,051.36 $689,051.36 BONDS Item Description of Items Estimated Unit Unit Cost Estimated Completed Completed No. Quanity Total Quanity Total --------------------------------------- I BONDS I EA $100,000.00 $100,000.00 1 $100,000.00 Thursday,October 7,2021 Page 4 of City Project Numbers 102240 DOE Nnllnl)el- 2240 Contract Name NORTHSIDE III OFFISITE WATER IMPROVEMENTS Estimate Number I Contract Limits TO SERVE TRADITION,CENTRAL PHASE Payment Number I Project Type PAVING&ALT For Period Ending 9/30/2021 Project Funding -------------------------------------- Sub-Total of Previous Unit $100,000.00 $100,000.00 -------------------------------------- 'I1mrsday,October 7,202I Page 5 of 7 City Project Numbers 102240 DOE Number 2240 Contract Name NORTHSIDE III OPFISITE WATER IMPROVEMENTS Estimate Number I Contract Limits TO SERVE TRADITION,CENTRAL PHASE Payment Number I Project Type PAVING&ALT For Period Ending 9/30/2021 Project Funding Contract Information Summary Original Contract Amount $8,780,000.00 Change Orders Change Order Number 1 $67,481.49 Change Order Number 2 $12,127.50 Change Order Number 3 $34,873.86 Change Order Number 4 $4,251.00 Total Contract Price $8,898,733.85 Total Cost of Work Completed $8,898,733.85 Less %Retained $0.00 Net Earncd $8,898,733.85 Em•ned This Period $8,898,733.85 Retainage This Period $0.00 iLess Liquidated Damages j Days @ /Day $0.00 !f LessPavemeut Deficiency $0.00 Less Penalty $0.00 Less Previous Payment $0.00 Plus Material on Hand Less 15% $0.00 Balance Due This Payment $8,898,733.85 I Thursday,October 7,2021 Page 6 of 7 City Project Numbers 102240 DOE Number 2240 Contract Name NOR'nISIDE III OFFISITE WATER IMPROVEMENTS Estimate Number 1 Contract Limits TO SERVE TRADITION,CENTRAL PHASE Payment Number I Project Type PAVING&ALT For Period Ending 9/30/2021 Project Funding Project Manager NA City Secretary Contract Number Inspectors MILLER,W / SUTTERFIELD Contact Date Coutraclor McKee Utility Inc. Contact Time 180 WD 2319 W Main Street Days Charged to Date 218 WD Prauge, OK 74864 Contact is .000000 Complete CITY OF FORT WORTH SUMMARY OF CHARGES Line Fund Account Center Amount Gross Retainage Net Funded -------------------------------------- Total Cost of Wo0i Completed $8,898,733.85 Less %Retained $0.00 Net Earned $8,898,733.85 Earned This Period $8,898,733.85 Retainage This Period $0.00 Less Liquidated Damages 0 Days @ $0.00 /Day $0.00 LessPovement Deficiency $0.00 Less Penalty $0.00 Less Previous Payment $0.00 Plus Material on Hand Less 15% $0.00 Balance Due This Payment $8,898,733.85 �I I Thursday,October 7,2021 Page 7 of 7 FORT WORTH TRANSPORTATION AND PUBLIC WORI{S PIPE REPORT FOR: PROJECT NAME: Northside III Offsite Water Improvements to Serve Traditions Central Phase PROJECT NUMBER: 102240 DOE NUMBER: N/A WATER PIPE LAID SIZE TYPE OF PIPE LF C 303 Concrete 36" concrete wrapped 11623 C 303 Concrete 36" Restrained Joint 8244 36"water pipe 36" water carrier pipe 604 16"DIP 16" DEP restrained joint 16 16"PVC 16" slip joint 1704 16"PVC 16" Restrained joint 330 16"DIP 16" DIP 301 12"PVC 12" slip joint 51 TIRE HYDRANTS: 1 ea VALVES(16"OR LARGER) 15 ea PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: yes NEW SERVICES: SEWER PIPE LAID SIZE TYPE OF PIPE LF PIPE ABANDONED SIZE TYPE OF PIPE LF DENSITIES: NEW SERVICES: TRANSPORTATION AND PUBLIC WORKS The City of Fort Worth-1000 Throckmorton Street•Dort Worth,rth,TX 76012-6311 n s' 1 (817)392-7941 •Faa:(817)392-7845 FORT WORT H., TRANSPORTATION AND PUBLIC NVORKS INSPECTION PUNCH LIST 1. Punch List on Headlight/Punch completed 9/22/2021 Contractor In'spcctor i-I ,S , 5 v fLr l E Lo � � ZZlZc.� Z CP iG 2- zL-jc7 i i I 2 % § ,m gn 2 �2 @ � 000 � ) )\ / /$ G 2 \ ° j S d k ® / m m ® ® § ¥ / 2 § § § ] J § ( j / o ] M 0 $§ / / -i § k cow & m © # m Q -, q2 § $ $ 7 \� rn 0 w o \ � > CD - $ § z 14 \ \ § cn / ® [ 2 7 \ ) [ / g }\ § ~ § � % } ; 2 ) \ \ ) k U} { / § & mEco ƒ j \ T 'U § ? \ § ® o E E ) ® o(D � / \ zz 0 ® j \ m R° o ~ 2 0 o k ` ) ( k � § S co co \ z \2 0-1 % | a ± kO n \ 2 ¥n . 0 0 �[ ® ® ; m Fm � / § \� ® , § \\ wn e / r r�• r� N 100 N ° 3 m 0 l ;u HT (l R, e N V' 0 o S N G1 ry n' ut 1t rD m 0 O° (o Sv to v 7 L, Q 3 G N _ N d cn =1 9 �U) �� 9 `.c� A :l fV fD .S to ro o 4 m N c�3 a tit v 0 t -� •� O t bo �\�^. O f fl n n to tv 4 O � M O O rn cN r\ 7! w Q O O d a D o o �./ j ❑ n m �,Y o ro u O' °° r �• m p\I mz m m Cy In S` ❑ C s rl• O' :. f2 rn C w, O f mCH ❑ a ry 3 0 p� :o Cu O K: n¢ C n i f � � � � • � p 't � C m -'� c fli p to G o rq v ! v % O to :•. Z ri a Z t NOto N •�O (D t� .�n C " A D O N Q to r D V. m P N ❑ o rn " o`� C J C: n YY o 3 � mo mm ' �r� TQ O RN � o V C V n to Q W O N r O m a4v Coto N ❑ U❑Z to n W � wit a, ,e°� .I Z •��' "{j D _I a'••, , ij (D a f m at to 'h. 'd " n o {u to n 0to h 0 0. D < ~ a' n _ to'o In Y' m0 Y. E;ty ° rt V) o o a) C2o N Gl ad c �v a to O 4 rD H 4 Y to w N N Matt Baacl(e From: Jason Buoy <jason@mckeeutility.com> Sent: Saturday,June 5,2021 3:56 PM To: Patel,Yogesh; Eddie Eckart;Matt Baacke Cc: Sood,Vishal;Wong,Soon;Harris, Melissa Subject: RE:Tradition NS-III (CON-20-0126)Change Order#1 Follow Up Flag: Flag for follow up Flag Status: Flagged Item A:(Keep In mind these excavations are in solid rock) • It looks like there is a sheet missing In the attachment for C01. Sheet 9 was revised on 8/18/20 to lower the ARV due to the dimension constraints with the Items housed In the manhole. This ARV was not able to be altered in size and elevation as we had begun laying pipe before the Issue was completely ironed out. This sheet netted an additional 613 CY. This Is the bulk of the cost related to this CO. • Sheets 12, 13,and 14 of the C01 attachment indicates to provide a credit for reduced elevation,makes no mention of the ARV's being overl.6 feet deeper at Sta 52+00 and 2.2 feet deeper at station 64+60 which results In an actual net change of close to 0 CY for these sheets. • Notes on sheet 22 Indicate to provide a credit for reduced excavation,makes no mention of the ARV at station I 137+00 being 1.4'deeper. This sheet netted an additional 89 CY of excavation. • Notes on sheet 23 indicate to provide a credit for reduced excavation,makes no mention of the ARV at station 154+00 being 1.64'deeper. This sheet netted an additional 89 CY of excavation. • Notes on sheet 27 Indicate to provide a credit for reduced excavation. There is no reduced excavation on this sheet from the original bid document. This sheet netted 0 CY of excavation. Item C • Bid documents Indicated contractor option for either.440"coated or.50" uncoated steel casing on the BNSF railroad permit. A revised permit was received after the bid on 8/21/20 and Indicated no options,only.440" coated was to be used. 0.50"uncoated casing had already been submitted and approved by 7/23/20 and subsequently ordered at that time,unbeknownst to McKee that a forthcoming change was going to occur with this. The cost change was to add coating to the casing. • Revised sheet 30 elevation of the pipeline was lowered by 1.8'between stations 64+77 and 67+94,resulting in additional excavation at the bore and receiving pit locations on either side of the railroad. Regards, Jason Buoy Mcl(ee Utility Contractors, Inc. 2319 West Main,Prague,0I(74864 Office:405.567.3666 Mobile:405,566.7833 I 9p RS a �'.qq 0 ap ��°A g 98 IMUMME STA 39100.00 I ,p 44 py c� o nj L. 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TRANSPORTATION AND PUBLIC WORKS September 22,2021 McKee Utility Contractors Inc. 2319 West Main Street Prauge, 0K 74864 RE: Acceptance Letter Project Name: Northside III Offsite Water Improvements to Serve Traditions Central Phase Project Type:Developer/Water City Project No.: 102240 I To Whom It May Concern: On August 26,2021 a final Inspection was made on the subject project. There were punch list items identified at that time. The punch list items were completed on September 22,2021. The final inspection and the corrected punch list items indicate that the work meets the City of Fort Worth specifications and is therefore accepted by the City. The warranty period will start on September 22, 2021,which is the date of the punch list completion and will extend of two(2)years in accordance with the Contract Documents. If you have any questions concerning this letter of acceptance, please feel free to contact me at 817- 392-2373. Sincerely, ges atel,PE(Oct 7,202112:39 CDT) Yogesh Patel,Project Manager Cc:Hershel Stanley Sutterfield, Inspector Wade Miller, Inspection Supervisor Shawn Fargo,Senior Inspector Victor V.Tornero, Program Manager Goodwin and Marshall,Consultant McKee Utility Contractor Inc.,Contractor HT Hwy 114 Development L.P.,Developer File E-Mail: Douglas W.Wiersig, P.E.,PhD., Director,TPW Chris Harder, P.E,,Assistant Director,Water Richard Martinez,Assistant Director,TPW Wendy Chi-Babulal, P.E.,Water Marisa Conlin,Traffic Engineering Tony Sholola,P.E.,Water Allen Hall,Superintendent,TPW Richard Zavala, Director,PARD John Robert Carman, P.E., Director,Water David Creek,Assistant Director,PARD ReV.9/15/16 AFFIDAVIT STATE OF OKLAHOMA COUNTY OF LINCOLN Before me,the undersigned authority, a notary public in the state and county aforesaid,on this day personally appeared Shane McKee, President Of McKee Utility Contractors, Inc., known to me to be a credible person,who being by me duly sworn, upon his oath deposed and said; That all persons,firms,associations, corporations, or other organizations furnishing labor and/or materials have been paid in full; That the wage scale established by the City Council in the City of Fort Worth has been paid in full; That there are no claims pending for personal injury and/or property damages; On Contract described as; Offsite Water Line NS - III to serve Tradition BY Shane McKee, President Subscribed and sworn before me on this date 30th of September, 2021. Notary Pu is Lincoln County, Oklahoma Q? PUB\ gyp. . BOND NO. 2306893 OWNrR ❑ CONSENT OF SURETY ARCIin•ICT ❑ TO FINAL PAYMENT CONTRACTOR ❑ Conforms with the American Institute of SURTiTY ❑ Architects,AIA Document G707 OTIIGR ❑ TO OWNER: ARCInTECT'S PROJECT NO.: (,Inure mul addrnrx) HT HWY 114 Development LP I 2200 Ross Ave.,Suite 4200 W CONTRACT I.OR: Dallas,TX 76201 PROJECT: CONTRACT DATED:July 2020 (Name and oddress) NS III Office Water Improvements to Serve Tradition,Central Phase In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above,the (liurri nante and addrem of®9 North American Specialty Insurnace Company 1450 American Lane,#1100 Schaumburg,IL 60173 ,SURETY, on bond of (Gum name nnJ nddreu of Contractor) McKee Utility Contractors,Inc. 2319 West Main Street Prague,OK 74864 ,CONTRACTOR, hereby approves of the final payment to the Contractor,and agrees that final payment to the Contractor shall not relieve the Surcly of any of its obligations to (Insert name and addrear of Arncr) HT HWY 114 Development LP 2200 Ross Ave.,Suite 4200 W Dallas,TX 75201 OWNER, as set forth in said Surety's bond. IN WITNESS WHEREOF,the Surety has hereunto set its hand on this date:September 30,2021 (lmertGnvltingtkenranth faUmredl9•the namericdareandpearj North American Specialty Ire urn ce,5rr?pany (Burch) ` Attest (.Signnnrc vmrpwrizedrepr er r n�) + I • r' Jamie Burris,Attorney-in-Fact Witness (Printed none and title) 5.21341GE 10101 XDP SWISS RE CORPORA•rE SOLUTIONS NORTII AMERICAN Sill'-CIALTY INSURANCE COMPANY WAS]IINGTON INTERNATIONAL INSURANCE COMPANY GENERAL POWER OF A'r'I'ORNEW KNOW ALL f+IEN Ifl''1'l1r:51:1'IiliSliNl'S,"rFIA f North American Specialty Insurance Company,a corporation duly organized and existing under laws of ilia State of New I lumpshirc,and having its principal office in ilia City of Kansas City,Missouri,anti Washington International Insurance Company,a corporation organized and existing under the laws of ilia State orNew Hampshire mid having its principal office in the City of Kansas City.*vlissuuri.each dues hereby make,constitute and appoint: JOHN K.IMIA.VAUMIN P.GRAIIAM.VAIM11.14I1. POLEMAN.TRAVIS E.ulUM14,9 ill0ltnu L.RAPER,bAMnC 11ueRIS.51ILLU It.%ANISIT. MARK It%I M I I I..A Atlm'(-\III:.S It KI tWl Sc11%111WSINK WHIMIAWAIAwTOSIfo1(LLL,(Aftf.wt-Kl INrItl'llbA11Y Ill IS.-III MA,KHRAt If JOINTLY Ott SEVERAL-IN Its Inte;Ind lawli l Auorneyisi-in-Fact,u)make,execute,seal and deliver,fair mid on its behulrand its its net and dead,bonds or other writings (lblieatoly in the nature of a boid on behalf of each of said Colupanics,as surety,on contracts orsurctysbip its are or may be required or permitted by law,regulation.contract or otherwise,provided that no bond or undertaking or contract or suretyship executed under this authority shall exceed the amumit of: FIFTY MILLION 650,000,(100,00)DOLLARS This Power of Attoncy is granted and is signed by facsimile under and by ilia authorily of the following Resolutions adopted by ilia Boards of Directors of both North American Specialty Insurance Company and Washington International Insurance Company at meetings duly called and held on the 411,of May,2012: "RESOLVED.that any two of the['residents,any Alanaging Director,any Senior Vice President,any Vice President,oily Assistant Vice President. ilia Secretary or any Assistant Secretary be.and each or tiny of Them hereby is authorized to execute a Power of Attorney qualifying ilia attorney named in the given Power of Auomcy to execute on behulrof the Company bonds,undertakings and all contracts of•surely.and[hat each or any of them hereby is authorized to attest to the execution orany such Power of Attorney and to attach therein Ilia seal of the Company; and it is FURTI-IER RESOLVED,that the signature of suet officers,ful the seal ordle Company cony be alfixed to any such Power of Ailonicy or to any f certificate relating thereto by facsimile,:mil any such Paver of Attorney or certificate bearing such facsimile signatures or facsimile seal shall be binding upon tine Company when so affixed and in ilia liuure with regard to any bond,undertaking or contract of surety to which it is attached." tlutuuuarrmp �,.o,� c//J a310NA4 V'h �yQ:aT(Pbikr..a' �""�"_ �(c5•'�gavd'•:!s� r�:u m':?.ice It}• �::�� �fF•. Andrnun,Sndnr%lerPmfJml arwathinannl lntonaflnnrl ln+urancr Compan, g7 SE of�Z 1073 w) fi&nlor Aia l'rc+IdrN of\orlh Antertau Sprctall)-Imuranrr Comp(n) ''',alit bOH•N`�`�� i7/ / "�.`'��'A4Y".�'�1 �i/L/IIIIRI1110111t 1` �r•....IY•..rA 0v , \litfiad A.lin.,roof n mi cm o iYaTitngmn in itnulu,na nmranrr nmpan) &Srnlor Vice 19ctfdau of xorth motrinn Sprclalq In+unnct Compsn) IN WITNESS WliliRliOF,North American Specialty Insurance Company and Washington International Insurance Company have caused their o0icial seals to be hereunto affixed,and these presents to be signed by their authorized officers this I Sill day of FGBRUARI' ,21121 North American Specialty Insurance Company Washington international Insurance Company State of Illinois County of Cook "' On this 1 Sth day or FEBRUARY ,2()21,bclifrc lie,a Notary Public personaly appeared Steven 11.Andaman ,Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company and Michael A.Ito, Senior Vice President of Washington International Insurance Company and Senior Vice President of North American Specialty Insurance Company,personally known to tie,who being by the duly sworn,acknowledged that they signed ilia above Power of Attorney as officers orand acknowledged said instrnnient to be the voluntary net and dead of their respective companies. OFFICIAL sea M -% Y i Nnr.lryruLficYctallLni+ A!/rurrm:mb.1,;4., M.Kcrnq•.i�'ulnry Ptddic IW44021 h Jcflicy Galdbcre doe duly elected Assistant Secretary of Nonh American Specialty insurance Company and Wishineion International Insurance Company,do hereby certify that the above and foregoing is a true and correct copy of a Power of Attorney givcu.b%said Noah American Specialty Insurance Company and Washington International insunmce Company.which is still in full force lidd e(1'c tt"", +' IN WITNESS WHI;HOF.I have set lily hand and affixed Idle seals of the Companies thin day of Unit)I;AdMr Y,cc rYnf�itd A+,a4%t Sr.vrj„f; �� wY+lungna tmrrnuEa>.II rnatnataY l""nmaq S\,vlh Arxtf..n Sxi V gin,it�n]tzCa,rp:n)